United We Stand

AMCLC 2012 underscores the importance of advocacy and engagement.

Encouraging member engagement, undertaking grassroots efforts, and curbing unnecessary imaging were all hot topics during the 89th AMCLC, held at the Washington Hilton Hotel in Washington, D.C.

Howard B. Fleishon, MD, MMM, FACR, ACR council speaker, called the meeting to order on Sunday, April 22, 2012, extending a warm welcome to councilors, alternate councilors, the Board of Chancellors (BOC), the Council Steering Committee (CSC), chapter officers, ACR members, residents, and other guests. Fleishon's opening speech touched on the specialty's obstacles and opportunities. "No doubt we are facing challenges," he acknowledged. "But look at our history ... with your energy, advocacy, and leadership, we will meet our challenges together and continue to be successful."

Thriving Under Pressure

Fleishon passed the microphone to Kenneth Korotky, ACR chief financial officer, who presented the CEO report on behalf of ACR CEO Harvey L. Neiman, MD, FACR. Korotky noted that the ACR is in good financial standing and lauded the accomplishments of the ACR Government Relations and Economics Departments, which serve as "the voice of our specialty in Washington, D.C." The principal advocacy issue in 2011, he explained, was stopping the Multiple Procedure Payment Reduction (MPPR) imposed by MedPAC and CMS. To address this concern, College staff and members organized and executed nationwide grassroots efforts. The activities paid off; the MPPR was reduced from 50 to 25 percent.

Korotky next illuminated the performance of the ACR Education Center, which recently held its 100th course and has served more than 3,700 radiologists. In the realm of education, the American Institute for Radiologic Pathology (AIRP) four-week rad-path correlation course also received attention. Since the ACR initiated sponsorship of the AIRP, attendance has set new records, and a new course syllabus iPad app has been created and downloaded more than 6,000 times in 80+ countries.

Meanwhile, the ACR Radiology Leadership Institute (RLI) was also touted for its role at the forefront of professional development in radiology. The RLI will hold its inaugural event in July 2012 at Northwestern University's Kellogg School of Management in Evanston, Ill., with keynote speaker Jeffrey R. Immelt, chair and CEO of General Electric. "The ACR continues to be a very busy, vibrant, and active society," Korotky said. "Perhaps that is why the membership currently stands at more than 36,000 members, which we are proud to say is an all-time high."

Immense Progress

Continuing to illustrate last year's major successes, John A. Patti, MD, FACR, outgoing BOC chair and new ACR president, next took the podium to provide his annual report.

Patti addressed the efforts of a number of task forces, including those listed below. Many of these groups have made strides in pinpointing topics of concern, and several have had written recommendations approved by the BOC:

The ACR also continues to collaborate with other societies, such as the RSNA, the American Association for Women Radiologists, and the International Society of Radiology. Related to international radiology, Patti reported that, with assistance from the Committee for International Quality and Safety, Committee on International Economics, and Committee on International Education and Meetings, the ACR is increasing its global influence.

A variety of new activities will also help the College cement its value within the radiology community. One such effort, which Patti highlighted, is participation in the new Choosing Wisely™ campaign, sponsored by the American Board of Internal Medicine Foundation. The campaign required the College to identify five imaging exams or procedures that should be discussed before ordering.

Such conversations between a patient and physician can help illustrate the value of radiology. Another unique way that the College helps demonstrate value is through value statements, which Patti noted were recently created by each ACR commission. Each value statement details an initiative, endeavor, or accomplishment undertaken by members within a specific commission or committee. These statements are available in the Case in Point daily e-mails (sign up at http://3s.acr.org/cip).

Finally, as he closed his speech, Patti applauded the College's advocacy efforts in 2011. "Through your commitment, your strength in numbers, and your unified voice, our specialty will continue to thrive," he concluded.

Avoiding the Perfect Storm

Later in the council session, Manuel L. Brown, MD, FACR, 2011-2012 ACR president, gave a heartfelt and passionate ACR Presidential Address as he called for more active engagement from both current and potential members. Such engagement, he noted, stands between the ACR and the elements gathering to form what he described as an eventual perfect storm that could undermine and commoditize the profession.

"We have seen the vastness of the College, but that is not enough. Member engagement will be essential to our well-being," he noted, emphasizing the difference between being passively content with the ACR and actively engaged with it. "Satisfaction is the foundation and the minimum requirement for a continuing relationship, while engagement extends beyond mere satisfaction."

To encourage member engagement, the College must maintain a common vision, continue to help members believe that they can make a positive difference, and recognize and reward individual effort, Brown stated. Although the College already provides many opportunities for members to enlist, he believes that many members may not know they exist. Members who already recognize that the College has so much to offer can help others become actively engaged to, for example, promote participation in educational programs and share other sources of information or boost involvement within state chapters.

When in doubt about how to participate, consider taking part in state chapters, which often need advocacy assistance. To illustrate the importance of grassroots action, Brown drew upon the example of the MPPR legislation presented during 2011. "I do not understand why all radiologists in the country did not call or write their representatives asking them to co-sponsor the bill to overturn the MPPR when it is abundantly clear that the concept and methodology was so very flawed, and when doing nothing would have a direct negative impact to each and every one of us," he noted.

"I challenge our College and all of our members to find ways to increase our membership numbers so that all radiation oncologists, all medical physicists, and all radiologists join the ACR," Brown concluded. "I challenge everyone to become more engaged in the work of our College." In response to his call to action, the captivated audience gave Brown a standing ovation.

Radiology's Next Generation

As part of Monday's AMCLC programming, leaders representing the 2011-2012 Resident and Fellow Section (RFS), the ABR, ACRIN®, and RTOG® informed the membership about activities, accomplishments, challenges, and plans for the future. Topics ranged from new website features to ground-breaking findings published in prestigious journals.

With a record number of participating residents and fellows — more than 5,000 individuals in more than 26 chapters — it was a big year for the RFS, explained Wendy D. Ellis, MD, outgoing RFS chair. Ellis and RFS members spent the previous year enhancing the RFS website (www.acr.org/Membership/Residents-and-Fellows) to meet the needs of all residents and fellows. Added features include the MRI teaching file and a group PowerPoint presentation on relevant topics — including the creation and evolution of Blue Cross Blue Shield and Kaiser Permanente, past national health-care legislation, and reform efforts — collectively titled "Health-Policy Milestones in Modern America."

The RFS is active in developing these and other resources to aid younger members of the ACR. "The future of the RFS is bright," Ellis emphasized, acknowledging the section's leadership. She concluded by expressing her thanks to ACR leadership for their continued support of the College's next generation of leaders.

Changes to MOC Requirements

In addition to the RFS, the ABR, which serves all radiologists in a critically important area: Maintenance of Certification (MOC), also provided a report. James P. Borgstede, MD, FACR, ABR president-elect, described how the new guidelines of the American Board of Medical Specialties (ABMS) affect ABR diplomates. A policy for all 24 ABMS member boards, effective Aug. 1, 2012, will have far-reaching consequences for physicians seeking to meet MOC requirements.

With this policy, Borgstede noted, boards with lifetime-certified diplomates would suddenly be labeled "not meeting MOC requirements" in the ABMS system. To resolve this issue, ABR will provide the public and diplomates with an MOC verification tool as well as accurate, timely, and complete information on diplomate status on the ABR website.

Research Making a Difference

Meeting attendees next learned about ACR research achievements, which include the publication of two significant ACRIN studies in the New England Journal of Medicine: "Lung Cancer Mortality Rate with Low-Dose CT Screening" and "CT Angiography for Safe Discharge of Patients with Possible Acute Coronary Syndromes." In addition to these studies, Mitchell D. Schnall, MD, PhD, ACRIN network chair, outlined other important, ongoing trials, including one that seeks to establish the role of PET/CT to reduce the morbidity of therapy for localized head and neck cancer.

In his message, Schnall also called attention to the oncologic research program merger of the Eastern Cooperative Oncology Group and ACRIN. This collaboration is designed to investigate "early detection and diagnosis of cancer; biomarker-driven phase II and phase III therapeutic studies for multiple cancer types and stages; and genetic, molecular, and imaging marker research to predict and monitor treatment response," he said, citing a March 18, 2011, ACRIN press release.

Following Schnall, Seth A. Rosenthal, MD, FACR, reported on RTOG activities on behalf of Walter J. Curran Jr., MD, FACR, RTOG chair. Rosenthal noted that 2011 was a "year of change" for RTOG as it moved toward a realigned cooperative group structure for its studies. As such, RTOG will partner with the National Surgical Adjuvant Breast and Bowel Project and the Gynecologic Oncology Group in upcoming research projects.